Widespread shortages of personal protective equipment (PPE) during the COVID-19 pandemic have placed health care workers at risk and threatened their ability to care for patients.1 Items in shortage include disposable filtering facepiece respirators ("N95 masks"), filter cartridges for powered airpurifying respirators, face shields, and surgical scrubs. Many of these shortages reflect fragile international supply chains based on just-in-time manufacturing and lean inventories. Ranney et al. recently identified several promising approaches to improving national coordination of PPE supply,2 but we believe that responses to health care emergencies must also be strengthened at the community level. This is a well-recognized concept in the setting of natural disasters,3 but to our knowledge the role of fabrication of medical products such as PPE by local companies and concerned citizens (including "maker" and 3D printing communities) has not been previously considered for disease pandemics. Local fabrication during the COVID-19 crisis has largely focused on face masks, respirators, and ventilator parts but could extend in future emergencies to stretchers, custom software, and transportation. For such solutions to be useful, they must be informed by regulatory and performance standards, and hospitals must have the data needed for adoption and deployment. Shifting regulatory guidance on PPE, the introduction of products from nontraditional suppliers, and an absence ofscientific data in many guidance documents have raised concerns among health care workers that evolving PPE standards may not be based on rigorous evidence.